The month of September, possibly more than any other month of the year, always elicits vivid memories. Back to school, new notebooks and pencils, new outfits that simply must be in the fashion-of-the-moment (remember Papagallo shoes?!), football season, marching band practice, and of course, a back-to-school checkup. And included in that checkup was always the eye chart with those huge letters which inevitably led to stronger glasses and, happily one year, contact lenses.

But since our eyes stop changing sometime in our teens and are stable until one day we realize we ‘re holding the newspaper out as far as our arms can reach leading us to run to the drugstore to buy reading glasses, we really no longer have to get eye checkups, do we? Regular mammograms and pelvic exams have replaced those yearly eye exams, right? Right and wrong. Yes, we do need annual mammograms and pelvic exams now that we are older, but we also still to need to visit the eye doctor regularly.

Why? Because in addition to becoming more and more farsighted, we are at risk for three major diseases of the eye as we age. Not only can these diseases show up with few or no symptoms, but they can also lead to blindness if not diagnosed and treated early. Like high blood pressure and high cholesterol, you may not even know you have one of these eye diseases; yet they can do a lot of damage despite being silent. What are those eye diseases accompanying aging? Cataracts, glaucoma and age-related macular degeneration (AMD).

In future columns, I will talk about each of these eye diseases in depth, including the symptoms, treatment and prevention. But for now, I will simply say that in recent years treatments to prevent blindness resulting from these major diseases of the aging eye, as well as information on how to prevent that blindness, have been discovered. Thus, the outlook for our aging eyes is better than ever before. But, only if these diseases are caught early in their course, which brings us full circle back to the absolute necessity that you get regular eye checkups.

What should these eye exams include, and how often should you get them? The official recommendations for the frequency of the exams is every one to two years if your eyes are healthy and you are having no symptoms up until age 65, after which you should have a yearly eye exam without fail. I actually recommend to my patients that after the age of 50, they have their eyes checked yearly, right along with those annual mammograms and pelvic exams. These eye exams should always include a vision check, a test of the pressure inside your eyeball (to look for glaucoma), and a dilated eye exam in which the back of your eye (the retina) is examined with a light. Make sure you see a qualified professional for this exam – either an ophthalmologist or an optometrist.

Is there anything else you can do to take care of your eyes and prevent blindness in addition to those regular eye exams? Actually, there are many things, which include:

• See your eye professional not only for regular routine eye exams, but also for any new symptoms you may have.
• Know if anyone in your family has had eye disease, and let your eye professional know. Having a family history of cataracts is a major risk for your getting them, and a positive family history of AMD has been been associated with your developing AMD as well.
• Get your other diseases – diabetes, high cholesterol, high blood pressure – under control. Diabetes is a major risk factor for cataracts, and high cholesterol as well as high blood pressure are both risk factors for AMD.
• Stop smoking! Cigarette smoking puts you at risk for both cataracts and age-related macular degeneration.
• Wear proper sunglasses. Unprotected overexposure to sunlight is a risk factor for cataracts and AMD. Your sunglasses should be coated with enough ultraviolet (UV) light-absorbing material to prevent cataract formation. Sunglasses that have a label saying “Meets ANSI Z80.3 General Purpose UV Requirements” meet this criterion, and are known as “general purpose sunglasses.” If you are at particular risk for cataracts because of having diabetes or having smoked cigarettes, or if your eye doctor has told you that you have early cataracts, wear only “special purpose” sunglasses; these fit snugly on the nose, wrap around the head, and block light from below, above, and both sides of the glasses. They should carry the label that says “the Skin Cancer Foundation’s Seal of Recommendation for Sunglasses.” Know, too, that polarized glasses cut glare, but do not protect against UV radiation. In addition to special purpose sunglasses, a large sunhat will take care of those extra rays.
• Know that any loss of vision – whether it is partial or complete, fleeting or longlasting – is never normal. Many times, the cause can be treated and the vision loss reversed. And, many times the vision loss is due to a cause other than an eye disease, such as a stroke, that also can be reversed if treated early enough. But, whatever the cause, it must be taken care of immediately. Call your eye professional and then go to the emergency room. (See the next point.) Also, if you think you had some vision loss in the past – even if it resolved completely – it may be a warning sign of a serious disease. Make an appointment to see your eye professional as soon as possible if this has happened to you.
• Know that not all emergency rooms have a qualified eye professional immediately available. Find out beforehand from your eye professional, such as during your routine annual eye exam, which emergency room in your area has emergency eye care always available, and go there.

Dr. Miller and I believe strongly that understanding your health and knowing your risk factors for specific diseases are absolute necessities for remaining healthy at this age and in the future. And this applies to the health of your total body, and not just your eyes. Taking care of yourself as beautifully as you have taken care of your loved ones all these years not only makes sense, but is absolutely a must for staying healthy and being active as the years pass. This belief is the foundation of our new book, The Smart Woman’s Guide to Midlife and Beyond: A No-Nonsense Approach to Staying Healthy after 50. Please visit our website for our book to learn more. www.smartwomanshealth.com

Janet Horn, M.D. Physician